Psychiatry's Hottest Niche Markets

Psychiatry's Hottest Niche Markets

Fluffy bath robes. In-room Jacuzzis. An evening at the theater with your psychiatrist. Welcome to the brave new world of high-end inpatient psychiatry.

Anxious to boost their bottom line, several established psychiatric facilities have opened exclusively self-pay inpatient units that promise to treat patients like royalty while treating them for a wide range of psychiatric and/or substance abuse problems.

In November 2002, Rhode Island's Butler Hospital opened Duncan Lodge, an impeccably furnished, five-patient unit so service-oriented that it would make executives at the Four Seasons hotel chain jumpy. Duncan Lodge joins The Pavilion at McLean Hospital and The Retreat at Sheppard Pratt as the latest entries to what may be psychiatry's hottest new niche market.

ŎI think there has long been a market out there for upscale, upgraded health facilities, just like hotels started to do five-star resorts,Ŏ William E. Callahan Jr., M.D., a San Francisco-based psychiatrist in private practice, told Psychiatric Times. ŎIn health care, when people are under stress and are not feeling well, [and] if they have the means, a lot of them are not going to want to go into a setting that isn't like a hotel or their home that's just another stressor.Ŏ

For rates ranging from $1,500 per day to $2,500 per day, patients can stay in elegantly furnished private rooms that offer high-speed Internet access, fresh flowers and the guarantee that reconstituted mashed potatoes will not be on the menu--unless, of course, the patient requests them. The programs accept patients from a full diagnostic spectrum, provided the patient can manage in an unlocked setting as determined by a thorough intake screening.

Not surprisingly, there are challenges unique to running a small high-end unit. ŎOn one hand, it's kind of cozy and people get a lot of attention, but the interpersonal transference-based things that get stirred up between patients and between staff and patients can get pretty intense,Ŏ Donald R. Ross, M.D., medical director of The Retreat at Sheppard Pratt, told PT. ŎCareful attention to professional boundaries is important.Ŏ

How to figure out where those boundaries lie is another matter. ŎIf you're going to try and treat people in a flexible and creative way, you're going to have to make some difficult decisions around that,Ŏ Alan Gordon, M.D., said in an interview with PT.